Biotechnology for environmental quality: Closing the circles

This paper examines the impact of biotechnology for enhancing the quality of the environment, and the necessity of encouraging holistic approaches to environmental problem solving. Current actions are considered wanting because they place insufficient attention on the causes of environmental degradation. In this context, a number of issues and research agendas are presented, a consideration of which leads me to opine that urgent priorities for ensuring lasting sustainable development must include the widespread adoption of clean technology and ecosystem restoration. Biotechnology has a particularly decisive role to play in realizing clean processes and clean products, and this role is illustrated with reference to clean technology options in the industrial, agroforestry, food, raw materials, and minerals sectors. A quarter of a century ago Commoner (1971) used the metaphor of a closing circle to draw attention to incompatibilities of modern industrial society and ecological health. The second part of this paper argues that, as biotechnology has matured, a circle of synergistic flows of materials, services and ideas has been established between it and biodiversity and suggests a more optimistic scenario to that portrayed by Commoner. The closing of the biotechnology-biodiversity circle is manifest in the following terms: search and discovery; detection, circumscription and phylogeny; ecosystem function and restoration; industrial ecology; and the gearing provided by molecular biology. Finally, the North-South biotechnology-biodiversity circle presents critical problems of commercial exploitation and intellectual property rights in relation to the gene pools of the megadiversity but predominantly developing countries of the world

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients